Make a Payment

Contact Information:

Phone

+1 (877) 828 – 3940

TTY/TDD

+1 (240) 580-1926

E-Mail

billing@infucarerx.com

Patient Information

Name *

First

Last

Invoice Number * Located on the under upper right side of your invoice

Invoice Date *

Email A receipt will be sent to this email

Payment Amount

Amount *

$

Payment Method

Credit/Debit Card

Bank Account

Name on Card *

First

Last

Card Number *

Expiration Date *

Security Code *

Zip Code *